Blood on dipstick urine testing

• chemical stix allow the detection of microscopic haematuria. The test is very sensitive and will detect red blood cells in numbers as low as 1-2 x 10^12 per litre. However there is no concensus as to what the 'normal' number of red blood cells should be. Recommendations vary between 2 and 5 per high power field on urine microscopy.
  
  
• a positive test should be followed by urine microscopy to confirm the presence of red blood cells and so exclude myoglobinuria and haemoglobinuria

Notes (2):

• red cells may be present in UTI, patients with persistent haematuria post UTI should be referred
• lab microscopy for red cells is less accurate than dipstick due to red cell lysis in transport

Reference:

1. Update (24/9/97), 354-8.
2. Health Protection Agency (Accessed 21/4/14). Diagnosis of UTI - Quick Reference Guide for Primary Care.